Tesis

Distribusi Kepadatan Dermatophagoides pteronyssinus (Der p) dan Korelasinya dengan Kadar Serum IgE dan IgG4 Spesifik Der p pada Penduduk di Purwokerto = Distribution Density of Dermatophagoides pteronyssinus (Der p) and Its Relation with the consentration of serum spesific Der p IgE and IgG4 Levels in the Purwokerto Population.

Tungau debu rumah (TDR) merupakan alergen pencetus Asma. Sebanyak 85% pasien asma, alergi terhadap Dermatophagoides pteronyssinus. Atopi adalah kecenderungan untuk menghasilkan antibodi IgE sebagai respons terhadap paparan alergen. Paparan berulang alergen menginduksi peningkatan sel T regulator yang memproduksi IL-10 yang dapat mempengaruhi switching produk subkelas antibodi dari sel B untuk memproduksi IgG4. Selama ini, IgE spesifik alergen dijadikan penanda adanya pajanan alergen namun hanya terdeteksi pada orang yang atopi sementara pada subjek normal penanda IgE ini tidak muncul adekuat maka diperlukan penanda imunologi (subkelas imunoglobulin) yang dapat digunakan untuk memindai adanya pajanan baik di subjek atopi maupun normal sehingga dapat digunakan untuk mendeteksi adanya sumber pajanan di suatu komunitas. Hal ini penting agar dapat dilakukan upaya pencegahan dan pengendalian asma. Berdasarkan hal tesebut, peneliti tertarik untuk mengetahui respon IgE dan IgG4 dan korelasinya dengan kepadatan TDR. Penelitian dilakukan pada bulan Juli 2018 sampai April 2019. Sebanyak 25 pasien asma atopi dan 21 subjek normal dilakukan pengukuran kadar serum IgE dan IgG4 Der p menggunakan metode indirek ELISA. Sampel debu rumah diambil dari rumah pasien, diidentifikasi dan dihitung jumlahnya menggunakan metode Hart & Fain. Hasil penelitian menunjukkan spesies TDR yang paling mendominasi yaitu D. pteronyssinus. Kadar serum IgE spesifik Der p pada pasien asma atopi lebih tinggi dibandingkan pasien normal (p=0,002) sedangkan kadar serum IgG4 spesifik Der p baik pada pasien asma atopi maupun normal tidak menunjukan beda signifikan (p=0,667). Kepadatan D. pteronyssinus baik di ruang tidur maupun ruang keluarga menunjukkan korelasi positif dengan kadar serum IgG4 Der p baik pada asma atopi maupun normal (Spearman,R=0,388,p=0,008). IgG4 spesifik Der p dapat dijadikan prediktor adanya TDR di rumah.
Kata Kunci : Kadar IgE, Kadar IgG4, Kepadatan, Der p


House dust mites (TDR) are allergens that trigger asthma. As many as 85% of asthma patients, are allergic to Dermatophagoides pteronyssinus. Atopy is the tendency to produce IgE antibodies in response to allergen exposure. Repeated exposure to allergens induces an increase in regulator T cells that produce IL-10 which can affect the switching of subclass antibody products from B cells to produce IgG4. During this time, allergen-specific IgE was used as a marker for allergen exposure but only detected in atopic people while in normal subjects this IgE marker did not appear adequately, immunological markers (subclass immunoglobulin) were needed which could be used to scan for exposure in both atopy and normal subjects so that can be used to detect sources of exposure in a community. This is important so that efforts can be made to prevent and control asthma. Based on this, the researchers were interested in knowing the response of IgE and IgG4 and their correlation with TDR density. The study was conducted in July 2018 until April 2019. A total of 25 atopic asthma patients and 21 normal subjects were measured for serum IgE and IgG4 Der p levels using the ELISA indirect method. House dust samples were taken from the patient's home, identified and counted using the Hart & Fain method. The results showed that the most dominant TDR species was D. pteronyssinus. Derp specific serum IgE levels in atopic asthma patients were higher than normal patients (p = 0.002) while Der p specific serum IgG4 levels in both atopic and normal asthma patients did not show significant differences (p = 0.667). Density of D. pteronyssinus in both the bedroom and family room showed a positive correlation with serum IgG4 Der p levels in both atopic and normal asthma (Spearman, R = 0.388, p = 0.008). Der p specific IgG4 can be a predictor of TDR at home.
Keywords: IgE Levels, IgG4 Levels, Density, Der p